title: Fibroblastic rheumatism: immunosuppressive therapy is not always required.
abstract: Fibroblastic rheumatism is a very rare cause of distal and bilateral polyarthritis characterized by cutaneous nodules, sclerodactylitis, thickened palmar fascia and Raynaud phenomenon. Physiopathology remains unknown and the diagnosis is histologic. Despite the use of immunosuppressive agents in some isolated cases with a variable efficacy, we report a case of typical fibroblastic rheumatism with severe digital retraction who dramatically improved after intensive physical therapy without immunosuppressive drugs prescription. Such a case illustrates that improvement may be spontaneous and that non pharmacological approach is a cornerstone in the management of this disease.
authors.affiliation: Service de rhumatologie, université Paris 06, hôpital Saint-Antoine, AP-HP, DHU « inflammation, immunopathologie, biothérapie » I2B, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Courties
authors.affiliation: Service de dermatologie, université Paris 06, hôpital Tenon, AP-HP, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Guégan
authors.affiliation: Service d'imagerie médicale, université Paris 06, hôpital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Miquel
authors.affiliation: Service d'anatomopathologie, université Paris 06, hôpital Tenon, AP-HP, Paris, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Duriez
authors.affiliation: Service de rhumatologie, université Paris 06, hôpital Saint-Antoine, AP-HP, DHU « inflammation, immunopathologie, biothérapie » I2B, Paris, France. Electronic address: francis.berenbaum@sat.aphp.fr.
authors.forename: Francis
authors.initials: F
authors.lastname: Berenbaum
authors.affiliation: Service de rhumatologie, université Paris 06, hôpital Saint-Antoine, AP-HP, DHU « inflammation, immunopathologie, biothérapie » I2B, Paris, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Sellam
mesh_terms: D000328:Adult; D005347:Fibroblasts / Q000473:pathology; D005355:Fibrosis; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000628:therapy*
keywords: Fibroblastic rheumatism; Immunosuppressive drugs; Non-pharmacological treatment; Physical therapy